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Does Medicare Cover Orthotics?

Christian Worstell by Christian Worstell    |    Published Oct 03, 2019    |    Reviewed by John Krahnert

Medicare does cover orthotics if you meet certain eligibility requirements.

If you have foot or back pain, a spinal injury, osteoarthritis or other orthopedic condition, your doctor may prescribe an orthotic device as a part of treatment. Learn more below.

Walking with a dog

Orthotics is a medical specialty concerned with the making and fitting of medical devices designed to support, align, relieve or correct orthopedic problems. These supportive orthotic devices are most commonly used to:

  • Facilitate healing following an injury or surgical procedure
  • Reduce pain by restricting mobility
  • Support weak or deformed joints and muscles

Medicare Does Pay for Orthotics

There are a wide variety of orthotics (prefabricated and custom-made) prescribed to patients that Medicare covers under the durable medical equipment (DME) benefit. Medicare orthotics can include:

  • Ankle, foot and knee bracing
  • Back, neck and spinal bracing
  • Hand, wrist and elbow bracing
  • Orthopedic shoes when they’re a necessary part of a leg brace
  • Prosthetic devices such as artificial limbs and eyes

In order for Medicare to cover your orthotics:

  • Your doctor or physician must determine that the orthotics are medically necessary and prescribe it as part of your treatment plan.
  • The DME suppliers you use must be enrolled in and participate in Medicare.

What Medicare Will Pay

Generally, if you meet all of the requirements for getting coverage, Medicare Part B will cover 80% of the Medicare-approved amount for orthotics, and then you typically pay the 20% Medicare Part B coinsurance out-of-pocket (after your annual Part B deductible is met).

 

Medicare Supplement Insurance can help cover your out-of-pocket orthotics costs.

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